Bronchogenic Carcinoma

Bronchogenic carcinoma is a malignant primary lung tumors, which originate from the respiratory tract.

Pathophysiology and Etiology
Etiology of bronchogenic carcinoma is not known definitely.
Factors that are considered influential:
Inhaled long-term (15-20 years) of carcinogenic substances,
such as:

• Cigarette smoke
• Exposure to industry: asbestos, nickel, "ion exchange resin", arsenic.
• Predisposing family relations / race (not clear).
• Scar tissue in the lung because of other diseases, like tuberculosis, pulmonary infarction.

Clinical Symptoms and Diagnosis
1. Symptoms intrapulmoner:

• Cough
• Coughing up blood
• Shortness of breath
• Chest pain
• Stridor unilateral

2. Symptoms intratorakal metastatic to other organs such as:

• Phrenic nerve: parese / paralise diaphragm.
• Recurrent nerve: parese / paralise vocal cords.
• Sympathetic nerves: from Horner's syndrome.
• Esophagus: disfagi.
• Superior vena cava: the superior vena cava syndrome.
• Traka & Bronchial: ateletaksis or shortness of breath.
• Cardiac: Functional impairment, effusion pericarditis.

3. Non-metastatic extrapulmonary symptoms:

• Neuromuscular: cause neuropatia carsinomatosa
• Endocrine disorders / metabolic : Cushing's syndrome, carcinoid syndrome, SIADH + hyponatremia, hyperparathyroidism hiperkalsemi + + hyperglycemia ginekomasti insulin secretion, hyperpigmentation.
• Disruption on the network: "hyperthrophy pulmonary osteoarthropathy". tissue / bone.
• Disturbances in vascular: 'thrombophlebitis migrans', anemia, purpura, and hematologic.

4. Extrapulmonary symptoms: the brain, liver, bone.
5. Systemic symptoms: anorexia.

Body weight decreased by more than 4 kg within 6 months.

Special Examination:

• X-ray photo chest, sputum cytology or biopsy material other.
• complete Bronchoscopy.
• lymph node biopsy, percutaneous lung biopsy.
• Bronchography, C.T scan and
• Surgical explorative.

Diagnosis
Based on the symptoms allegedly due to bronchogenic carcinoma and accompanied by a special examination support.

Differential Diagnosis

• The foreign objects.
• Fungi.
• Tuberculosis.
• Hamartoma.
• Metastatic tumors.
• Autoimmune Diseases.

Management Of Bronchogenic carcinoma
A. Bronchogenic carcinoma Non-Small Cell Type.

If still operabel then performed the operation.
For non operabel cases, palliative treatment.

B. Bronchogenic carcinoma Small Cell Type.

Generally not operated on, and therefore usually has spread at the time of the diagnosis.
For evaluation purposes, TMN staging was not done, but divided into:
"Limited disease": tumor limited to the hemitoraks and ipsilateral gland.
"Extensive disease": the tumor has spread beyond (1).

Prevention
Cigarettes are the leading cause of bronchogenic carcinoma.
But if people quit smoking for 3 years, the risk of bronchogenic carcinoma becomes smaller than the original. If the patient stops smoking for 10-13 years, the risk of bronchogenic carcinoma together with individuals who are not smokers.

Prognosis
5-year survival ("5 years survival rate").

• To bronchogenic carcinoma Small Cell Type = 0%.
• To bronchogenic carcinoma Non-Small Cell types depending on the stages and do surgery or not.

Phase I + operation: for epidermoid carcinoma = 54%. adenocarcinoma cell & large = 51%.
Phase II + operation: epidermoid carcinoma = 35%. adenocarcinoma cell & large = 18%.
Without surgery: survival of 5 years, less than 10%.

Tags : bronchogenic cancer, small cell carcinoma, bronchogenic carcinoma symptoms, bronchial carcinoma